CIHR grant helping shed light on perinatal access

Canada-wide project aims to look at provincial data to help create a national perinatal health strategy

Marg SheridanMar 28, 2017 1:13 PM

“Even knowing where people (live) and where they deliver can tell us a lot”

Roxanne Laforge

A pair of College of Medicine researchers are taking part in a national collaborative research project that aims at creating a national strategy to help improve perinatal care.

And a newly awarded Canadian Institutes of Health Research (CIHR) grant will give the team a boost.

“Dr. George Carson from the Department of Obstetrics, Gynecology and Reproductive Sciences and I are part of a pan-Canadian group of 58 researchers, health care providers, decision makers, and knowledge translation partners who have signed on to this ambitious project” said Roxanne Laforge, a Registered Nurse and Coordinator of the Perinatal Education Program, which is joint with the Division of Continuing Medical Education and Continuing and Distance Education, College of Nursing. “Over the course of this five-year grant we hope to be able to assess a variety of issues that impact how women receive obstetrical care – including geography, climate, emergency transport and the provision of care and services in rural and remote areas.”

Laforge says the ultimate goal would be to use the data compiled by each province to help create national recommendations to improve care across the country.

“Overall when we take a look at perinatal health care in the country we do relatively well, but there’s room for improvement,” Laforge continued. “We know that outcomes vary greatly across regions because of factors such as where babies are born, socio-economic status, rural vs. urban residence, Aboriginal status and other factors. Like other provinces, closure of obstetrical services in low volume hospitals has resulted in a need for low-risk pregnant women to travel long distances to have their baby.

“This has a significant impact on the system, as low-risk women travel long distances to deliver in a facility intended for higher-risk women. More importantly, it really impacts on the woman and her family who must leave her community and supports to deliver her baby.”

Saskatchewan has a relatively high infant mortality rate when compared to the Canadian national average and it’s an area that the province and health care providers have been working hard to improve. But there are also other areas of care that the province does well when compared to the rest of Canada. So this project will hopefully help to determine what is contributing, both positively and negatively, to perinatal outcomes.

“Some of the provinces have very robust database, such as British Columbia, Alberta , Ontario and Nova Scotia because they have perinatal registries” Laforge explained. “So if a woman has a baby in B.C. they have a large number of indicators that they can access to provide them with information, including some that help identify determinants of health, such as education, where does she live, does she have other health conditions such as diabetes or high BMI.

“Even knowing where people (live) and where they deliver can tell us a lot.”

And while Ontario, Alberta and B.C. are the three provinces with the largest databases, and therefore likely will be providing a large chunk of the data, Laforge hopes that her involvement alongside the work being done by Dr. Carson on the project will help to spur the growth of Saskatchewan’s current perinatal data collection.

“The national project is a big one, and the one of the comments made by the CIHR committee was that the relatively modest $1 million over five-years grant would probably leave the team underfunded,” Laforge stressed. “They thought it was very ambitious, (but) we’re looking for (a) national strategy to improve the system. So there’s lots to do.”